System for correcting an irregular surface of a cornea and uses thereof

ABSTRACT

Provided are systems and methods for correcting a corneal surface irregularity surface in a subject. The system generally comprises a infrared laser, for example, and infrared laser and a laser control unit, a corneal contacting unit, a gel solidifying unit and an electronic device tangibly storing algorithms to operate the units. In the methods, a polymerizable or thermo-reversible gel or polymerized resin is applied to the anterior corneal surface and solidified as a layer over the cornea. A first correcting cut is lasered into the stroma of an applanated cornea, the gel layer is then removed and a second correcting cut is lasered in the stroma of the applanated cornea. The lenticule formed intrastromaly by the first and second correcting cuts is removed such that the cornea has a corrected corneal curvature.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims benefit of priority under 35U.S.C. § 119(e) to provisional application U.S. Ser. No. 62/395,793,filed Sep. 16, 2016, the entirety of which is hereby incorporated byreference.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention generally relates to the field of ophthalmology.More specifically, the present invention relates to a system forsmoothing an irregular surface of a cornea during an opthalmologicalsurgery, such as a femto refractive surgery.

Description of the Related Art

Femto refractive surgery has become fairly common in recent years forits high accuracy and low risk approaches. Over the past decades, thesystems along with the operation procedures have been significantlyimproved to maximize the efficacy and minimize the side effects of thistype of surgeries.

For example, Kuehnert et al. in U.S. Pat. No. 8,491,575 B2 describes alaser system and the correcting apparatus for generating a correctingcut surface in the cornea of an eye to correct ametropia. The systemcomprises a laser unit to emit pulsed laser radiation, a control unitfor control of the laser unit, as well as a contact element releasablycoupled to the laser unit and specifically adapted for the respectivecorrecting cut surface. The pulse duration is, for example, within thefemtosecond range (e.g. 50 to 800 fs), with a pulse repetition rate ofbetween 10 and 500 kHz.

The pulsed laser radiation is focused through the contact element intothe cornea of an eye. Focusing is effected by two deflecting mirrorsthat form a movable scanner and by the optics. Scanning occurs under thecontrol of the control unit, so that basically any desired locations inthe cornea can be exposed to the pulsed laser radiation. The controlunit controls the laser unit such that an optical breakthrough isgenerated at the respective focus position in the cornea to separatetissue. The focus positions are selected to be adjacent to each othersuch that a desired cut surface is present in the cornea.

The laser unit and control unit disclosed in U.S. Pat. No. 8,491,575 canbe utilized, for example, in the same manner as in a conventional laserkeratome, such as used in the so-called LASIK method (laser in situkeratomileusis) to cut a thin lamella (often referred to also as flap)which is unilaterally detached from the cornea. Thus, the optics, merelyrepresented as a lens, can comprise several optical elements aresuitably arranged along the beam path from the laser up to the contactelement. For example, the apparatus may further comprise at least athird contact element, which imposes a further curvature upon theanterior corneal surface when contacting the latter, the furthercurvature deviating from the standard curvature as well as from theactual curvature of the second contact element, and thus has the effectthat a cut surface generated using the standard setting results in afurther correcting cut surface.

Moreover, the contact surface of the corresponding contact elementdefining the actual curvature may be flexible. The flexibility isselected such that minor irregularities can be compensated for althoughon average the actual curvature is imposed upon the anterior cornealsurface. This has the advantageous effect that the correcting cutsurface to be generated has an extremely smooth profile. However, whilethe flexibility may be achieved, for example, by a thin, flexible layer,e.g. a gel layer, forming the contact surface, which is in turn appliedto a contact element carrier that is rigid with respect to the cornea,the flexible layer disclosed in U.S. Pat. No. 8,491,575 is pre-moldedand has limited ability to deform in situ to fit into the cornealsurface irregularities.

Therefore, there is a recognized need in the art for an opthalmologicalsurgical system and method that comprises a gel layer that fills theirregularities on the anterior surface of a cornea. Particularly, theprior art is deficient in an opthalmologically useful gel to smooth theirregularities in a femto refractive surgery. The present inventionfulfills this long-standing need and desire in the art.

SUMMARY OF THE INVENTION

The present invention is directed to a system for smoothing an irregularcorneal surface of an eye to correct vision in a subject. The systemcomprises a laser unit comprising a pulsed laser emitter and a lasercontrol unit in electronic communication with the laser unit. A cornealcontacting unit is in electronic communication with the laser controlunit and is positionable proximate to a corneal surface. A gelsolidifying unit is configured to initiate a polymerization or athermo-reversible solidification of a gel composition. An electronicdevice comprising a processor and a memory tangibly stores an algorithmcomprising processor-executable instructions configured to operate theunits.

The present invention also is directed to a method for smoothing anirregular surface of a cornea in an eye prior to an ophthalmologicalsurgical procedure. The method comprises applying a polymerizable orthermo-reversible gel to an anterior corneal surface of the eye andmolding the gel over the anterior corneal surface. The gel issolidified, via the gel solidifying unit comprising the system describedherein, as a layer covering the anterior corneal surface, therebysmoothing irregularities present in the corneal surface.

The present invention is directed further to a method for performing asurgical procedure to correct a defect in eyesight of a subject. Themethod comprises forming a solidified gel layer of a minimum thicknessover an anterior corneal surface of an eye via the system describedherein. A first correcting surface cut is lasered on the cornea throughthe solidified gel layer and the solidified gel layer is removed. Theanterior corneal surface of the eye is contacted with a second contactelement. A vacuum is applied to form a second curvature defined by thecontacting surface of the second contact element to the anterior surfaceof the cornea. A second surface cut is lasered when the vacuum isapplied where the second surface cut intersects the first correctingsurface cut such that a lenticule is formed in the cornea. The lenticuleis removed from the cornea to form a corrected corneal curvature therebycorrecting the defect in eyesight of the subject.

Other and further aspects, features, and advantages of the presentinvention will be apparent from the following description of thepresently preferred embodiments of the invention given for the purposeof disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

So that the matter in which the above-recited features, advantages andobjects of the invention, as well as others that will become clear, areattained and can be understood in detail, more particular descriptionsof the invention briefly summarized above may be by reference to certainembodiments thereof that are illustrated in the appended drawings. Thesedrawings form a part of the specification. It is to be noted, however,that the appended drawings illustrate preferred embodiments of theinvention and therefore are not to be considered limiting in theirscope.

FIG. 1 is a schematic representation of the positioning of a contactelement with respect to the anterior corneal surface prior toapplanation of the cornea.

FIG. 2 is a schematic representation of the standard surface cutgenerated in the cornea during applanation by the contact element usingfemtolaser technology.

FIG. 3 is a schematic representation of the application of an amount ofgel over a corneal surface irregularity.

FIG. 4 is a schematic representation of the placement of the contactelement for molding the gel.

FIG. 5 is a schematic representation of the use of a contact element toform a gel layer of a minimum thickness between the irregular cornealsurface and the contacting surface of the contact element.

FIG. 6 is a schematic representation of the application of UV radiationfor solidification of the gel.

FIG. 7 is a schematic representation of creating the first correctingcut into the stroma using a femto-laser beam.

FIG. 8 is a schematic representation of the cornea and first correctingsurface cut after removal of the gel.

FIG. 9 is a schematic representation of the contact element in contactwith the cornea and first correcting cut after applying a vacuum withouta gel layer.

FIG. 10 is a schematic representation of creating the second correctingsurface cut into the stroma using a femto-laser beam.

FIG. 11 is a schematic representation of the first and second correctingsurface cuts and the intrastromally created lenticule.

FIG. 12 is a schematic representation of the corneal surface with thecorrected curvature.

DETAILED DESCRIPTION OF THE INVENTION

As used herein in the specification, “a” or “an” may mean one or more.As used herein in the claim(s), when used in conjunction with the word“comprising”, the words “a” or “an” may mean one or more than one.

As used herein “another” or “other” may mean at least a second or moreof the same or different claim element or components thereof. Similarly,the word “or” is intended to include “and” unless the context clearlyindicates otherwise. “Comprise” means “include.”

As used herein, the term “about” refers to a numeric value, including,for example, whole numbers, fractions, and percentages, whether or notexplicitly indicated. The term “about” generally refers to a range ofnumerical values (e.g., +1-5-10% of the recited value) that one ofordinary skill in the art would consider equivalent to the recited value(e.g., having the same function or result). In some instances, the term“about” may include numerical values that are rounded to the nearestsignificant figure.

As used herein, the term “lenticule” refers to the area on a corneaformed when correcting surface cuts and standard surface cuts are madeon the anterior corneal surface of an eye. Removing the so formedlenticule creates a desired curvature of the cornea that corrects adefect in eyesight.

As used herein, the term “subject” refers to a recipient of the methodsto correct a defect in vision via the systems described herein.Preferably, the subject is a human.

In one embodiment of the present invention, there is provided a systemfor smoothing an irregular corneal surface of an eye to correct visionin a subject, comprising a laser unit comprising a pulsed laser emitter;a laser control unit in electronic communication with the laser unit; acorneal contacting unit in electronic communication with the lasercontrol unit positionable proximate to a corneal surface; a gelsolidifying unit configured to initiate a polymerization or athermo-reversible solidification of a gel composition; and an electronicdevice comprising a processor and a memory tangibly storing an algorithmcomprising processor-executable instructions to operate the units.

In this embodiment the laser emitter may be configured to pulse laserradiation within a femtosecond range with a frequency of about 10 Hz toabout 500 kHz. Also, the laser control unit may be configured to controla duration, positioning and intensity of the emitted pulsed laserradiation. In addition the algorithm may comprise processor-executableinstructions to identify a curvature to achieve a desired final cornealcurvature.

Also in this embodiment an example of a polymerizable gel may bepolyurethane methacrylate (PUMA). In another example the polymerizablegel comprises a polyester and a catalyst Methyl Ethyl Ketone Peroxide(MEKP). In yet another example, the polymerizable gel may be a hydrogel.In addition in this embodiment, a thermo-reversible gel composition maycomprise a soluble collagen solution. Examples of the collagen are aporcine collagen, a bovine collagen or a combination thereof.

In one aspect of this embodiment the corneal contacting unit maycomprise a first contact element having a concave contacting surfaceremovably contactable with an anterior corneal surface with the gelcomposition applied thereon; a second contact element having a concavecontacting surface removably contactable with an anterior cornealsurface without the gel applied thereon; and a vacuum applicatordisposed on the second contact element configured to produce a curvatureof the anterior corneal surface corresponding to the concave contactingsurface. In this aspect, when a mean corneal index is about 1.4Diopters, a difference of a corneal refractive index between the corneaand a solidified gel composition is less than about 0.5 Diopter.

In another aspect the gel solidifying unit may comprise an ultravioletlight emitter configured for triggering a polymerization of apolymerizable gel composition; a cooling unit configured for solidifyinga thermos-reversible gel composition by cooling or a combinationthereof; a liquid emitter configured to apply a catalyst on a solidifiedpolymerized resin; or a combination thereof. Further to this aspect, thegel solidifying unit may comprise an applicator configured to apply thegel composition between the anterior corneal surface and the contactingsurface of the corneal contacting unit.

In another embodiment of the present invention there is provided amethod for smoothing an irregular surface of a cornea in an eye prior toan ophthalmological surgical procedure, comprising the steps of applyinga polymerizable or thermo-reversible gel to an anterior corneal surfaceof the eye; molding the gel over the anterior corneal surface; andsolidifying the gel via the gel solidifying unit comprising the systemas described supra as a layer covering the anterior corneal surface,thereby smoothing irregularities present in the anterior cornealsurface.

In one aspect of this embodiment the applying step may comprisedelivering via an applicator a minimum amount of the gel onto thecorneal surface.

In another aspect the molding step may comprise selecting a firstcontact element having a concave surface curvature corresponding to acurvature effective to correct a defect in eyesight; and positioning thecontact element on the cornea such that the gel interfaces with theconcave surface of the contact element and the anterior corneal surfaceof the eye.

In yet another aspect the solidifying step may comprise irradiating thepolymerizable gel layer with ultraviolet radiation. Alternatively, thesolidifying step may comprise cooling the thermo-reversible gel layer.In another alternative, the solidifying step may comprise chemicallyfixing the gel composition by applying a chemical fixation agent.

In yet another embodiment of the present invention there is provided amethod for performing a surgical procedure to correct a defect ineyesight of a subject, comprising the steps of forming a solidified gellayer of a minimum thickness over an anterior corneal surface of an eyevia the system as described supra; lasering a first correcting surfacecut on the cornea through the solidified gel layer; removing thesolidified gel layer; contacting the anterior corneal surface of the eyewith a second contact element; applying a vacuum to form a secondcurvature defined by the contacting surface of the second contactelement to the anterior surface of the cornea; lasering a second surfacecut when the vacuum is applied, where the second surface cut intersectsthe first correcting surface cut such that a lenticule is formed on thecornea; and removing the lenticule from the cornea to form a correctedcorneal curvature thereby correcting the defect in eyesight of thesubject.

In an aspect of this embodiment the step of forming a solidified gellayer may comprise delivering via an applicator a minimum amount of apolymerizable gel, a polymerized resin or a thermo-reversible gel ontothe corneal surface; positioning a first contact element on the corneasuch that the gel interfaces with a concave contacting surface of thefirst contact element and the anterior corneal surface of the eye; andirradiating the polymerizable gel layer with ultraviolet radiation orcooling the thermo-reversible gel or chemically modifying thepolymerized resin, thereby solidifying the gel. In this aspect the priorto the positioning step, the method may comprise applying an algorithmto identify a first curvature corresponding to the first surface cut anda second curvature corresponding to the second surface cut; selecting afirst contact element having a contacting surface curvaturecorresponding to the first curvature; and selecting a second contactelement having a contacting surface curvature corresponding to thesecond curvature. Further to these aspects, the method may compriseapplying the algorithm to configure a laser to cut the cornea to producea first cut surface with a curvature corresponding to the firstcurvature of the selected first contact element, and a second cutsurface with a curvature corresponding to the second curvature of theselected second contact element.

In another aspect of this embodiment, the lasering steps may compriseselecting a duration, positioning and intensity of laser radiation; andpulsing the laser radiation within a femtosecond range with a frequencyof about 10 Hz to about 500 kHz to produce the first and second cutsurfaces.

Provided herein are systems and methods for smoothing an irregularanterior surface of a cornea during an ophthalmological surgicalprocedure, for example, a femto refractive surgery. Surface smoothing isdone by applying a biocompatible composition, such as a polymerizable orthermo-reversible gel or collagen composition, as a layer over theanterior corneal surface of the eye. A vacuum applied to the compositionforms a layer of a minimum thickness between the corneal surface and theapplanation component of a contact element, such as a concave contactingsurface, of the surgical system disposed over the corneal surface. Uponsolidification the layer fills any surface irregularities present on thecorneal surface and provides a smooth interface. The composition isapplied by any suitable means known in the art, for example, but notlimited to, a syringe-like applicator.

The biocompatible composition may comprise, but is not limited to, apolymerizable gel, such as polyurethane methacrylate. Alternatively, thebiocompatible composition may be a thermally modified gel orthermo-reversible collagen composition. The thermally modified gel maycomprise a chemically modified soluble collagen solution and apolymerization agent. Examples of a thermo-reversible collagencomposition include, but are not limited to, soluble porcine collagen,bovine collagen or other type of collagen or a combination thereof.Solidification of the composition is initiated by the application ofultraviolet light or cooling as is known in the art. Further thebiocompatible composition may comprise a resin polymerized by acatalyst. An example of a polymerized resin is a polyester polymerizedby Methyl Ethyl Ketone Peroxide (MEKP).

The system described herein comprises a plurality of units in electroniccommunication that are configured to produce the smoothing layer and togenerate one or more surface cuts in the stroma of the cornea. Forexample, the system may generally comprise a laser unit with a pulsedlaser emitter and a laser control unit. The laser is configured to emitpulsed laser radiation and is controlled by the control unit to generateone or more correcting surface cuts on the corneal stroma to produce asmoothed corneal surface with a final curvature selected to correct oneor more defects in a subject's eyesight. In a non-limiting example, thelaser radiation may be pulsed with a femtosecond range with a frequencyof about 10 Hz to about 500 kHz. The control unit controls at least theduration, positioning and intensity of the emitted pulsed laserradiation.

The corneal contacting unit applanates the solidified layer and/or theanterior corneal surface via the application of a vacuum prior togenerating the correcting surface cuts thereon. The contact elementcomprising the unit provides, with the corneal surface, a boundary forthe solidified gel or collagen interface. The system also comprises agel solidifying unit with which the biocompatible composition is appliedand solidified as described herein. For example, the solidifying unitmay comprise an ultraviolet light emitter and/or a cooling unit toeffect polymerization or solidification.

Generally, the system comprises an electronic device, such as a computeror smart device as are known in the art, having a memory, a processorand at least one network connection, on which to tangibly store one ormore algorithms. The algorithm(s) comprise processor-executableinstructions that function to or are configured to operate the unitscomprising the system. Particularly, the algorithm executes to identifya curvature to achieve a final corrected corneal curvature and/or toconfigure a laser to cut the cornea to produce the first and second cutsurfaces with a curvature corresponding to the curvature of the selectedcontact element.

Also provided are methods of using the described system. For example thesystem is useful for smoothing an irregular surface of a cornea in aneye prior to an ophthalmological surgical procedure, such as a femtorefractive surgery. Moreover, the system provided herein may be used toperform a surgical procedure to correct a defect in eyesight of asubject. As described herein, after producing the solidified smoothinglayer over the anterior corneal surface, a final desired curvature maybe determined and the correcting surface cuts planned to effect acorrection in eyesight. The skilled person well knows that the selectionof applanation curvatures and final corrective curvatures depend on theparticular subject and their specific defects in vision.

As described below, the invention provides a number of advantages anduses, however such advantages and uses are not limited by suchdescription. Embodiments of the present invention are better illustratedwith reference to the Figure(s), however, such reference is not meant tolimit the present invention in any fashion. The embodiments andvariations described in detail herein are to be interpreted by theappended claims and equivalents thereof.

FIG. 1 depicts a general system without a gel layer or interfacedisposed between the contact element, such as a flap contact glass 1 aof the system and the anterior corneal surface 4. In the surgical systemthe laser unit and the control unit (not shown) are configured to cut aflap using the flap contact glass 1 a. The standard setting is definedhere for the flap contact glass 1 a which comprises an inner, concavelycurved contact surface or flap contact surface 2 a that faces or isdisposed proximately to the cornea 3. The standard setting for thecontrol unit is adapted to the flap contact glass 1 a and to thecurvature imposed upon the anterior corneal surface 4 by the flapcontact surface 2 a, such that the standard surface cut 5 (the dashedline in FIG. 2) can be generated.

With continued reference to FIG. 1, FIG. 2 illustrates the standardsurface cut 5 generated during a cutting operation once the anteriorcorneal surface 4 has the standard curvature predetermined by the flapcontact surface 2 a of the flap contact glass 1 a. The standard surfacecut 5 is generated such the distance from the cut surface to theanterior corneal surface 4 is constant. In order to create the desiredcut, an opening cut 6 extending substantially perpendicular from theanterior corneal surface is made. In FIG. 2, the profile of the anteriorcorneal surface 4 is depicted with a natural curvature without theirregularities, such as a recess, that occur in an actual cornea. Thus,the standard surface cut 5 generated relative to the corneal surface 4,known as a reference surface, is depicted with the same curvature. Thestandard surface cut 5 described in FIG. 2 is not representative of adesired correcting surface cut to correct defective eyesight(ametropia), but serves to characterize the standard setting for thecontrol unit.

FIG. 3 illustrates how a small quantity of a suitable gel 7 is appliedto the cornea. A syringe-like or other type of gel applicator 8 enablesa user to control the amount and placement of the composition onto theanterior corneal surface.

FIG. 4 shows that the flap contact glass, known as the first contactelement 1 a, is positioned over and in contact with the applied gel 7.The contact surface 2 a works as a molding surface to mold the appliedgel over and into the irregularities on the anterior corneal surface.

FIG. 5 illustrates how the flap contact surface 2 a creates a newsurface over the anterior corneal surface with a minimal quantity of gel7 filling the space between the corneal surface and the molding surfaceof the first contact element 1 a. The gel 7 imposes an actual curvatureupon the cornea 3, which is modified as compared to the standardcurvature. For this purpose preoperative corneal topography orkeratometry data can be utilized to predetermine the given cornealsurface curvature for the correction of the irregularities including theametropia. In general, methods similar to these used for contact lensfitting can be used for flap contact glass selection. For visioncorrecting, the use of a flap contact glass, or first contact element 1a, that optimally fits the to be treated cornea 3 is imperative. Theflap contact glass 1 a may be selected from a series of pre-existentflap contact glasses.

With continued reference to FIG. 5, FIG. 6 illustrates thepolymerization of a polymerizable gel to form the gel layer 7 as a layerof minimum thickness over the irregular corneal surface afterpositioning of the flap contact glass. The delivery of ultraviolet (UV)radiation initiates polymerization of the gel. The polymerized gel layeror interface smoothes out the corneal irregularities.

FIG. 7 depicts the first correcting surface cut 9 illustrated by adotted line. The first correcting cut through the polymerized gel layeris generated by pulses in a femtosecond range of laser radiation via thelaser and laser control units (not shown) using the standard setting asknown in the art.

FIG. 8 depicts first correcting cut surface 9 after the femtosecondlaser cut is completed after the first contact element 1 a (see FIG. 7)and the remaining polymerized gel layer (see FIG. 7) are removed fromthe cornea.

FIG. 9 illustrates how the second flap contact glass, know as the secondcontact element 1 b, is positioned on the first correcting cut surface 9of the cornea 3 after the first correcting cut is made. Vacuum, which isapplied on the second contact element, is used to fit the firstcorrecting cut surface on the cornea to contact surface or moldingsurface 2 b without the gel.

FIG. 10 depicts a second cut or standard cut 10, shown by a dashed line,that is generated via laser radiation as described. The second standardcut 10 is on the top of the first correcting surface cut 9 to produce alenticule 11 (see FIG. 11).

FIG. 11 illustrates that after the second flap contact glass 1 b isremoved from the cornea both the correcting cut surface 9 and the secondstandard cut 10 confine the desired lenticule 11. For correction ofdefective eyesight, a corneal lenticule 11 has to be separated from thecornea 3, such that the thus-modified curvature of the anterior cornealsurface results in the desired correction of defective eyesight.

FIG. 12 depicts the anterior corneal surface 12 after the lenticule isremoved from a small incision. After removal the second standard cutsurface 10 comes to rest on the first correcting cut surface 9 and formsthe anterior corneal surface 12 with the desired curvature so that thecorrection of defective eyesight is achieved. The profile of thedistance between the correcting cut surface and the anterior cornealsurface or the reference surface varies patient by patient.

The present invention is well adapted to attain the ends and advantagesmentioned as well as those that are inherent therein. The particularembodiments disclosed above are illustrative only, as the presentinvention may be modified and practiced in different but equivalentmanners apparent to those skilled in the field having the benefit of theteachings herein. Furthermore, no limitations are intended to thedetails of construction or design herein shown, other than as describedin the claims below. It is therefore evident that the particularillustrative embodiments disclosed above may be altered or modified andall such variations are considered within the scope and spirit of thepresent invention.

What is claimed is:
 1. A method for correcting a defect in eyesight of asubject during a surgical procedure, comprising the steps of:solidifying a layer of a biocompatible composition between a firstcontact element removably positioned on a cornea of an eye and ananterior corneal surface of the eye to form a solidified layer of aminimum thickness; lasering a first correcting surface cut on the corneathrough the solidified layer; removing the solidified layer; contactingthe anterior corneal surface of the eye with a second contact element;applying a vacuum to form a curvature defined by a contacting surface ofthe second contact element to the anterior surface of the cornea;lasering a second surface cut when the vacuum is applied, said secondsurface cut intersecting the first correcting surface cut such that alenticule is formed on the cornea; and removing the lenticule from thecornea to form a corrected corneal curvature thereby correcting thedefect in eyesight of the subject.
 2. The method of claim 1, wherein thesolidifying step comprises: delivering via an applicator a minimumamount of the biocompatible composition onto the corneal surface;positioning the first contact element on the cornea such that thebiocompatible composition interfaces with a concave contacting surfaceof the first contact element and the anterior corneal surface of the eyeas a layer thereon; and irradiating the layer with ultraviolet radiationor cooling the layer or chemically modifying the layer, therebysolidifying the biocompatible composition as the layer of minimumthickness.
 3. The method of claim 2, wherein prior to the positioningstep, the method comprises: applying an algorithm to identify a firstcurvature corresponding to the first surface cut and a second curvaturecorresponding to the second surface cut; selecting a first contactelement having a contacting surface curvature corresponding to the firstcurvature; and selecting a second contact element having a contactingsurface curvature corresponding to the second curvature.
 4. The methodof claim 3, further comprising: applying the algorithm to configure alaser to cut the cornea to produce a first cut surface with a curvaturecorresponding to the first curvature of the selected first contactelement and a second cut surface with a curvature corresponding to thesecond curvature of the selected second contact element.
 5. The methodof claim 1, wherein the lasering step comprises: selecting a duration,positioning and intensity of laser radiation; and pulsing, via a pulsedlaser emitter, the laser radiation within a femtosecond range with afrequency of about 10 Hz to about 500 kHz to produce the first andsecond cut surfaces.
 6. The method of claim 1, wherein the biocompatiblecomposition is a UV polymerizable gel, a thermo-reversible gel or apolymerized resin.
 7. The method of claim 6, wherein the UVpolymerizable gel comprises polyurethane methacrylate (PUMA).
 8. Themethod of claim 6, wherein the UV polymerizable gel is a hydrogel. 9.The method of claim 6, wherein the thermo-reversible gel comprises asoluble collagen.
 10. The method of claim 9, wherein the solublecollagen is a porcine collagen or a bovine collagen or a combinationthereof.
 11. The method of claim 6, wherein the polymerized resincomprises a polyester polymerized by Methyl Ethyl Ketone Peroxide(MEKP).